title: A 5 item version of the Compliance Questionnaire for Rheumatology (CQR5) successfully identifies low adherence to DMARDs.
abstract: BACKGROUND
  Taking DMARDs as prescribed is an essential part of self-management for patients with Rheumatoid Arthritis. To date, the Compliance Questionnaire for Rheumatology (CQR) is the only self-report adherence measure created specifically for and validated in rheumatic diseases. However, the factor structure of the CQR has not been reported and it can be considered lengthy at 19 items. The aim of this study was to test the factor structure of the CQR and reduce the number of items whilst retaining robust explanation of non-adherence to DMARDs. Such a reduction would increase the clinical utility of the scale, to identify patients with sub-optimal adherence to DMARDs in the clinic as well as for research purposes.
  
  
  METHODS
  An exploratory factor analysis was performed to reduce the number of items in the CQR and then a confirmatory factor analysis was run to establish the fit of a 5 item version (CQR5) to the data. A discriminant function analysis was performed to determine the optimal combination of questions to identify suboptimal adherence.
  
  
  RESULTS
  The factor analyses identified a unidimensional 5 item model that explains 50.3% of the variance in adherence and has good internal consistency and fit to the data. Discriminant function analysis shows that the CQR5 can affectively detect 69% of low adherers to DMARDs using Fisher's weighted regression equation.
  
  
  CONCLUSIONS
  A shortened version of the CQR increases the clinical utility by reducing the patient burden whilst maintaining a good level of reliability and validity for a short, self-administered, self-report questionnaire.
authors.affiliation: Health Psychology Section, Institute of Psychiatry, King's College London, 5th Floor Bermondsey Wing, Guy's Hospital, London SE1 9RT, England. Lyndsay.hughes@kcl.ac.uk.
authors.forename: Lyndsay D
authors.initials: LD
authors.lastname: Hughes
authors.forename: John
authors.initials: J
authors.lastname: Done
authors.forename: Adam
authors.initials: A
authors.lastname: Young
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy*; D016002:Discriminant Analysis; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015203:Reproducibility of Results; D057566:Self Report; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents